3. Dropped beats that are not preceded by a change in the length of the PR interval . These abrupt, nonconducted P waves result in a pathologic condition.

C. Mobitz Type II

3. PR interval is prolonged (>200 msec). Asymptomatic

A. AV block 1st degree

4. Chaotic and erratic baseline with no discrete p waves in between irregularly spaced QRS complexes

F. Atrial Fibrillation

5. The atria and ventricles beat independently of each other. Both P waves and QRS complexes are present, although the P waves bear no relation to the QRS complexes. The atrial rate is faster than the ventricular rate.

D. 3rd Degree, complete AV block

6. A completely erratic rhythm with no identifiable waves.

E. Ventricular Fibrillation

a fatal arrythmia witho immediate defibrillation

Name five compensatory mechanisms that are activated when baroreceptors detect low MAP

Hypothalamus releases TRH which stimulates TSH from the pituitary which stiumlates follicle cells

What prevents there from being too much thyroid hormone?

Negative feedback of T3 to the anterior pituitary: decreases sensitivity to TRH from hypothalamus

What also stimulates follicle cells (pathological)?

TSI - Grave's disease

Describe how T3 andd T4 are made?

Iodine enters follicle cells and is oxidized; goes into lumen as I2. Thyroglobulin (made from tyrosine) enters lumen and combines with I2 to form monoiodotyrosine and di-iodotyroside (2 of di makes T4 and one di and one mono makes T3). The T3 and T4 re-enter the follicular cell and are degraded by proteolysis, releasing the T3 and T4 into the bloodstream

How doees a steroid hormone effect its function?

Binds to a receptor in the nucleus or cytoplasm and moves to the nucleus; the receptor transforms to expose the DNA binding domain and the hormone/receptor complex binds to an enhancer-like element in DNA. Bottom line: steroids and thyroid hormone cause gene transcription and protein formation

Why are the actions of steroid and thyroid hormones delayed?

You have to wait for the gene transcription and protein synthesis to happen.

What are the steroid hormones?

I had a PET CAT who was buff because she took steroids. Progesterone, Estrogen, Testosterone, Cortisol, Aldosterone, Thyroxine

How do steroids circulate if they are lipophilic?

Bound to binding globulins: increases their solubility and allows for increased delivery to the target organ

What enzyme does ACTH work on?

Desmolase: convesion of cholesterol to pregnenolone

What does ketoconazole do?

Inhibits desmolase, see above

What happens if you have a 17 alpha hydroxylase deficiency?

You can't make sex hormones, cortisol but you can make mineralcorticoids. You get hypertension and hypokalemia because you are wasting all the K in your kidneys while retaining Na. You are phenotypically femal but have no maturation.

What happens in 21 beta hydroxylase deficiency?

This is the most common. You have decreased cortisol, increased ACTH, decreased mineralcorticoids, and increased sex hormones. You are masculinized and have female pseudohermaphroditism.

What is blood pressure and electrolytes in 21 beta hydroxylase deficiency?

What cells can take in glucose regardless of insulin levels? Via what receptoir?

Bran and RBC: GLUT-1 receptor

What does the brain use in starvation when there is no glucose?

Ketone bodies

What does prolactin have to do with dopamine?

Prolactin increases dopamine synthesis and secretion from the hypothalamus, which then inhbits prolactin secretion

What do dopamine agonists do to prolactin secretion? Eg bromocriptine

Inhibit it

What does prolactin do to GnRH and what does this mean clinically?

Inhbitis synthesis and release: inhibits ovulation

What is a common sign of prolactinoma?

Amenorrhea

What causes prolactin releas?

TRH from hypothalamus works on anterior pituitary to cause prolactin release

What is the order of potency for estrone, striol, estradiol?

Most to least: estradiol >estrone>estriol

Where does estradiol come from?

Ovary

Do the testes make estrogen?

Yes

Where does estriol come from?

Placenta

What are the benefits of hormone replacement therapy with estrogen post-menopause?

Less hot flashes, less bone loss

What are the negative effects of unopposed estrogen?

Increased risk of endometrial cancer.

What can decrease the risks of giving estrogen?

Giving progesterone with it.

What does estrogen do to the follicle?

Makes it grow

What does estrogen do to the endometrium and the myometrium?

Growth and excitability

What does estrogen do to the genitalia?

Development

What does estrogen do to breasts?

Stromal development

What does estrogen do to fat distribution?

Female pattern

What does estrogen do to transport proteins?

Increases hepatic synthesis

What does estrogen do to FSH?

Feedback inhibition

What does estrogen do to LH?

Causes surge: feedback switches from negative to posititve just before LH surge.

What does increased progesterone indicate?

Ovulation

What does progesterone come from?

Corpus luteum, placenta, adrenal cortex, testes.

What does progesterone do to the endometrial glands and spinal artery development?

Increase secretions, increase artery growth

What does progesterone do for a pregnancy?

Maintains it

What doe progesterone do to myometrial excitability?

Decreases it

What does progesterone do to sperm travel?

Creates thick cervical mucus that inhibits sperm entry into uterus

What does progesterone do to body temperature?

Increases

What does progesterone do to gonadotropins?

Inhibits (LH, FSH)

What does progesterone do to uterine smooth muscle?

Relaxes

Follicular grwoth is fastest when?

during the 2nd week of the proliferative phase

The grafian follicle matures when?

The proliferative phase day 0-14

What is the sequence of Hormone surges prior to Ovulation?

Estrogen surge, then LH surge along with FSH surge.

When does Progesterone surge

During the Secreoty phase days 14-21

What hormone is associated with the Maintance of the Endometrium

Progesterone

What is the sorce of hCG

The syncytiotrophoblasts

What is Function of hCG: 1- physiologic, 2-diagnostic, 3-diagnostic

1- maintains the corpus luteum throughout the 1st trimester (acts like LH) 2- is useful for pregancy detection. Appears in urine 8 days post fertilization, 3- hCG is elevated in wone with hydatidiform moles

What is the average age of Menopause

51 (earlier in smokers)

Wge linked decline in number of ovarian follicles is associeated with decline in what hormone